Health Education and Health Promotion

Empowering Teenagers at Integrated Health Posts (Posyandu) in the Prevention of Early Marriage and Unwanted Pregnancy: A Structural Equation Modeling (SEM) Analysis of Coastal Adolescent Reproductive Health, South Konawe Regency, Southeast Sulawesi Province, Indonesia, 2025

Articles in Press

Document Type : Original Research

Authors

Rahman Rahman
Ruslan Majid
Yusuf Sabilu
Suhadi Suhadi
Lade Albar Kalza
La Ode Ahmad Saktiansyah
Sri Tungga Dewi

Halu Oleo University

58209/hehp.2026.119936.0
Abstract
Background: Adolescents in coastal areas face heightened risks of early marriage and unwanted pregnancy due to limited access to reproductive health services and enduring socio-cultural norms. In South Konawe Regency, Southeast Sulawesi, Youth Posyandu functions as a community-based adolescent health platform, yet its effectiveness in preventing early marriage and unwanted pregnancy in coastal communities remains underexamined.
Methods: This quantitative cross-sectional study involved 210 adolescents selected through proportional random sampling. Partial Least Squares–Structural Equation Modeling (PLS-SEM) was employed to examine direct effects as well as mediating and moderating relationships among knowledge, attitudes, program-supporting and inhibiting factors, Youth Posyandu empowerment, early marriage, and unwanted pregnancy.
Results: Program-supporting and inhibiting factors significantly influenced unwanted pregnancy (t = 2.881; p = 0.004). Knowledge showed a significant positive effect on unwanted pregnancy (t = 6.644; p < 0.001) and Youth Posyandu empowerment (t = 6.168; p < 0.001). Attitudes significantly affected unwanted pregnancy (t = 6.090; p < 0.001) but had no significant effect on empowerment (t = 0.479; p > 0.05). Youth Posyandu empowerment significantly reduced unwanted pregnancy (t = 2.566; p = 0.010). Mediation analysis revealed that empowerment partially mediated the effect of knowledge on early marriage and unwanted pregnancy (coefficient = −0.061; t = 2.112; p = 0.035), while attitudes showed no mediating effect. Program factors did not moderate the relationship between empowerment and unwanted pregnancy.
Conclusion: Enhancing adolescent knowledge and strengthening Youth Posyandu empowerment are key strategies for preventing early marriage and unwanted pregnancy in coastal communities.

Keywords

Empowering
Integrated health post
Teenagers
Prevention
early marriage
unwanted pregnancy
Subjects
Health Education and Health Promotion

Articles in Press, Accepted Manuscript
Available Online from 25 May 2026